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Efficacy of pressure gradient measurement using peripheral fractional flow reserve in common femoral artery: a case report
BACKGROUND: The severity of peripheral artery disease (PAD) is usually diagnosed by physiological assessments, such as the ankle brachial index (ABI) or peak systolic velocity (PSV) on ultrasonography. We examined peripheral fractional flow reserve (pFFR: distal mean pressure divided by proximal mea...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668065/ https://www.ncbi.nlm.nih.gov/pubmed/36405536 http://dx.doi.org/10.1093/ehjcr/ytac426 |
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author | Nakamura, Yuki Okabe, Hiroki Doi, Hideki Kataoka, Masaharu |
author_facet | Nakamura, Yuki Okabe, Hiroki Doi, Hideki Kataoka, Masaharu |
author_sort | Nakamura, Yuki |
collection | PubMed |
description | BACKGROUND: The severity of peripheral artery disease (PAD) is usually diagnosed by physiological assessments, such as the ankle brachial index (ABI) or peak systolic velocity (PSV) on ultrasonography. We examined peripheral fractional flow reserve (pFFR: distal mean pressure divided by proximal mean pressure) measured by a pressure wire and pressure gradient to diagnose PAD patients who do not have lowered ABI or high PSV on ultrasonography. CASE SUMMARY: An 84-year-old woman with intermittent claudication in her left leg had severe calcification in the left common femoral artery (CFA) on angiography. The exercise-stress ABI of pre-endovascular therapy (EVT) was 1.05/0.98. In addition, the PSV of the left CFA on ultrasonography was 230 cm/s. However, the pFFR using papaverine and alprostadil in the left CFA was 0.86, which was a significant score. In addition, the systolic pressure gradient between the distal and proximal regions was >20 mmHg. We performed EVT for the lesion, and the pFFR improved to 0.96. The systolic pressure gradient was only 1 mmHg at the lesion. DISCUSSION: Symptomatic PAD patients whose ABI or PSV on ultrasonography is insufficient for EVT could be diagnosed with ischaemia using a pressure gradient and pFFR. |
format | Online Article Text |
id | pubmed-9668065 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-96680652022-11-17 Efficacy of pressure gradient measurement using peripheral fractional flow reserve in common femoral artery: a case report Nakamura, Yuki Okabe, Hiroki Doi, Hideki Kataoka, Masaharu Eur Heart J Case Rep Case Report BACKGROUND: The severity of peripheral artery disease (PAD) is usually diagnosed by physiological assessments, such as the ankle brachial index (ABI) or peak systolic velocity (PSV) on ultrasonography. We examined peripheral fractional flow reserve (pFFR: distal mean pressure divided by proximal mean pressure) measured by a pressure wire and pressure gradient to diagnose PAD patients who do not have lowered ABI or high PSV on ultrasonography. CASE SUMMARY: An 84-year-old woman with intermittent claudication in her left leg had severe calcification in the left common femoral artery (CFA) on angiography. The exercise-stress ABI of pre-endovascular therapy (EVT) was 1.05/0.98. In addition, the PSV of the left CFA on ultrasonography was 230 cm/s. However, the pFFR using papaverine and alprostadil in the left CFA was 0.86, which was a significant score. In addition, the systolic pressure gradient between the distal and proximal regions was >20 mmHg. We performed EVT for the lesion, and the pFFR improved to 0.96. The systolic pressure gradient was only 1 mmHg at the lesion. DISCUSSION: Symptomatic PAD patients whose ABI or PSV on ultrasonography is insufficient for EVT could be diagnosed with ischaemia using a pressure gradient and pFFR. Oxford University Press 2022-10-28 /pmc/articles/PMC9668065/ /pubmed/36405536 http://dx.doi.org/10.1093/ehjcr/ytac426 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Case Report Nakamura, Yuki Okabe, Hiroki Doi, Hideki Kataoka, Masaharu Efficacy of pressure gradient measurement using peripheral fractional flow reserve in common femoral artery: a case report |
title | Efficacy of pressure gradient measurement using peripheral fractional flow reserve in common femoral artery: a case report |
title_full | Efficacy of pressure gradient measurement using peripheral fractional flow reserve in common femoral artery: a case report |
title_fullStr | Efficacy of pressure gradient measurement using peripheral fractional flow reserve in common femoral artery: a case report |
title_full_unstemmed | Efficacy of pressure gradient measurement using peripheral fractional flow reserve in common femoral artery: a case report |
title_short | Efficacy of pressure gradient measurement using peripheral fractional flow reserve in common femoral artery: a case report |
title_sort | efficacy of pressure gradient measurement using peripheral fractional flow reserve in common femoral artery: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668065/ https://www.ncbi.nlm.nih.gov/pubmed/36405536 http://dx.doi.org/10.1093/ehjcr/ytac426 |
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